Cardiovascular risk in special populations: The elderly.

Abstract Age is the main risk factor for cardiovascular disease. Age increases cardiovascular risk not only because it increases the exposure time to, the number of, and severity of other cardiovascular risk factors, but it is also able to change the system through a CV aging process. Aging per se causes an alteration of the vascular system, which involves the endothelial function, the vascular wall, and the related signaling cascades. These changes provide an important contribution to cardiovascular risk in the elderly population. At the same time life expectancy is constantly increasing and the elderly deserve a good prevention strategy. New algorithms to predict cardiovascular events are under construction and validation. These new algorithms are trying to integrate new biomarkers with the most important cardiovascular risk factors, which are powerful predictors in adults. In our opinion, at the current state of knowledge, treatment should be designed taking into account the characteristics of the patient, without making exceptions on the criteria of age. Also the goals of treatment should be similar to those of young adult subjects if the elderly patient has a good life expectancy, while the goals of treatment in the frail elderly patient with co-morbidity and reduced life expectancy should be to avoid complications of treatment with less stringent targets.